This paper is only available as a PDF. To read, Please Download here.
To characterize the patient population and clinical features of recurrent infective endocarditis, 117 patients with 142 episodes of infective endocarditis were investigated. Sixty-one (52 per cent) of the total population were drug abusers. Of the 96 who survived the initial episode of infective endocarditis, 58, including 34 drug abusers, were followed for a mean duration of 128 weeks. Recurrent infective endocarditis occurred in 18 of 58 (31 per cent); 14 of 34 (41 per cent) of drug abusers versus four of 24 (17 per cent) of nondrug users (P < 0.05). In addition to drug abuse, prior heart disease and periodontitis were each related (P < 0.05) to recurrence. Patients with ⪰ two risk factors for endocarditis were more likely (P < 0.05) to have a recurrence than those with only one risk factor. Causative organism and site of infection were similar with initial and recurrent infections. Although congestive heart failure complicating aortic and mitral valve infections occurred more frequently in recurrent versus initial infection (15 of 15 versus 43 of 72; P < 0.05), systemic emboli were documented with similar frequency (P > 0.05). Excluding debilitated patients, mortality was greater in those with recurrent versus initial infections (six of 24 versus nine of 96; P < 0.05). Each of three habitual drug abusers who survived insertion of a valvular prosthesis for the initial infection had a recurrence versus none of eight nondrug abusers with prosthetic valves (P < 0.05). Thus, recurrent endocarditis is a commonly encountered and often grave complication of infective endocarditis, particularly among chronic drug abusers.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Gulstonian Lectures on Malignant Endocarditis.Lancet. 1885; 1: M
- Gulstonian Lectures on Malignant Endocarditis.Lancet. 1885; 1: 415
- Infective endocarditis.Post Graduate Med. 1975; 58: 107
- Infective endocarditis at the Presbyterian Hospital in New York City from 1938–1967.Am J Med. 1971; 51: 83
- Changing etiology of bacterial endocarditis in the antibacterial era.Ann Intern Med. 1970; 72: 341
- A long term view of bacterial endocarditis.Ann Intern Med. 1965; 63: 185
- Infective endocarditis. A review of 125 cases from the University of Washington Hospitals 1963–1972.Medicine (Baltimore). 1977; 56: 287
- Bacterial endocarditis: A review of 148 cases.Am J Med. 1962; 32: 910
- Subacute bacterial endocarditis at the University of Minnesota Hospital 1939 through 1959.Ann Intern Med. 1961; 55: 550
- Characteristics of patients with multiple episodes of bacterial endocarditis.JAMA. 1970; 211: 1355
- Infective endocarditis—an evolving disease.Medicine (Baltimore). 1978; 57: 105
- Bacterial endocarditis in the antibiotic era.Circulation. 1959; 19: 753
- Bacterial endocarditis; survey of patients treated between 1948 and 1956.Br Med J. 1958; 1: 63
- Subacute bacterial endocarditis.Br Med J. 1960; 1: 1235
- Characteristics of bacterial endocarditis in heroin addicts in Detroit.Am J Med Sci. 1976; 271: 197
- Infective endocarditis in drug addicts.S Med J. 1974; 67: 4
- Infective endocarditis in heroin addicts.Am J Med. 1973; 56: 444
- Infective endocarditis in drug addicts. Experience with medical and surgical treatment.Circulation. 1973; 27–48: 37
- Comparison of infective endocarditis in drug addicts and non-drug users.Am J Cardiol. 1973; 32: 924
- Dental status and recurrence of Streptococcus viridans endocarditis.Lancet. 1971; 1: 1205
- Bacterial endocarditis: a cardiologist's view of dental involvement.Oral Surg. 1976; 42: 240
- Infective endocarditis in patients treated for malignant neoplasms: a post-mortem study.Am J Clin Pathol. 1973; 60: 241
- Late prosthetic valve endocarditis: clinical features influencing therapy.Am J Med. 1978; 64: 199
- Infective endocarditis.in: Cure Rates and Long-Term Prognosis. vol 14. University Press, Baltimore, Maryland1976: 209
Accepted: January 8, 1979
☆This study was presented in part at the 51st Scientific Sessions of the American Heart Association, Dallas, Texas, November 15, 1978. It was supported in part by the National Heart, Lung and Blood Vessel Research and Demonstration Center, Baylor College of Medicine, NHLBI, HL -17269.
© 1979 Published by Elsevier Inc.